Alopecia areata (A.A.) is a common disorder that produces sudden patchy hari loss and an autoimmune process has been implicated in its pathogenesis. The aim of the present work was to carry out an immunohistochemical study on the localized type of A.A. Thirty patients were enrolled in the study (21 males and 9 females). Complete history taking, physical and dermatological examination were done for each patient. Immunohistochemical staining using immunoperoxidase technique for T-lymphocytes (CD4), HLA-DR, and ICAM-1 were one on skin punch biopsis taken from the active lesions of A.A. patients. Results were compared with 20 age matched controls. In this study, males outnumbered females. The age range was 8-47 years (mean 23.6 ± 9.34), and the mean duration (8.59 ± 9.98) months. Difference between mean age of the patients and mean age at onset of the diseases between progressive and stable group were not statistically significant. Patients in the progressive stage had history of recurrence of AA. Associated diseases and nail changes were found in 23.3% of patients. CD4 lymphocytic infiltrate, ICAM-1, and HLA-DR were significantly increased in the hair follicles, preibulbar/dermal papilla zone, with enhanced expression of ICAM-1 in the vascular endothelium in A.A. patients and being more in the progressive phase of the disease, which coincides with the previous reports. However, it is not known whether the progressive localized A.A. would proceed to alopecia universalis or are they of different disease entity. This enhance the importance of carrying further studies on the cytokine profile of patients with the progressive phase since some reports claimed to have different patterns. |
